DId you apply the gel before the blood test? if so how far
if you applied it 45-1 hour it still was not peaking yet possible explaining the low testosteorne and may be your body is metabolising estrogen efficenctly.

Just a theory is that depending on how thick your skin is and absorption rate and possible hypothyroidism . It may have activated the aromatse first spiking the estrogen and then testosterone took longer to absorbs

Did you take hcg on day you took blood test?
hcg has half life of 48-60 hours so you might have been peaking on the HCG for the urine test..

Tell you what i wil never go back to creames or gels 4 weeks 22 lbs gain. I Should have listen a long time ago and stop being a cry baby about needles. Half inch works perfectly fine for me ..

How was your estrogen metabolism ratio of good :bad if it was elevated with more good then bad estrogen of 39 is not bad, but inrealtions ship to testosterone YIKES. Remember you may have started out with high estrogen but its over a total of 24 hour that is the most important. Blood tests are just space and time thats all..need to look at the whole picture which urine tests do.

DING DONG
It just clicked that an excess on a urine test can mean actualy a defieincy..so about not metabolizing would make more sense since the testosterone receptors would be blocked possiblly by estrogen so they have no where to bind and just get pissed out

Are you using fish oils, How was the total estrogen (e1,e2,e3) levels.

Right now you need have Dr john go over this and to tweak your protcol he is your dr and one of the best in the business !!

I cannot help you with your question sorry.
But you have unique opportunity to give us inside to Rhein consulting urine tests and specially their reporting on results.
On their web site they say that they provide profesional interpretation of results.
If you have a time please post as much as you wish, (up to and including retyping of the whole test) I would be much obligated.
I thoght that the most important reason for doing this urine test is to get idea about estrogens mapout, 2/16 ratio specifically.
But I am sure there is more value in that test than just the 2/16 ratio I just do not know what it is.
Thank you.
============================== ============
your blood, get (Free, bioavailable and total testosterone) (from Quest) and adjust so your free and bio are as much as possible on top but not over.Off hand you are low on T and high on E2.
You have locked out on SHBG, I think ideal level.
++++++++++++++++++++++++++++++ ++++++++++++

The blood test was at 8:30, before applying the gel, and the hcg was the day before.

Originally Posted by hardasnails1973

Did you take hcg on day you took blood test?

No, but I did take it the day the urine was collected.

Originally Posted by hardasnails1973

DING DONG
It just clicked that an excess on a urine test can mean actualy a defieincy..so about not metabolizing would make more sense since the testosterone receptors would be blocked possiblly by estrogen so they have no where to bind and just get pissed out

I thoght that the most important reason for doing this urine test is to get idea about estrogens mapout, 2/16 ratio specifically.
But I am sure there is more value in that test than just the 2/16 ratio I just do not know what it is.
Thank you.

E1 was 6.3 (3-12)
2-OH-Estrone was 7.5
16-a-OH-Estrone was not detected
4-OH-Estrone was not detected

This is good news. I wasn't even taking DIM or TMG for the prior month.

More blood test results, ordered by the urologist that found my varicocele. Later the same day as the AM blood was drawn (results above), PM blood was drawn (about 7 hours after applying Androgel which was applied right after the 8:30 am draw).

E1 was 6.3 (3-12)
2-OH-Estrone was 7.5
16-a-OH-Estrone was not detected
4-OH-Estrone was not detected

This is good news. I wasn't even taking DIM or TMG for the prior month.

I slapped on 10% cream 1 ml and test only came up to 307 3 hours before the test so this means I was not absorbing it. Urine test are tricky because an what looks like an excess may be defieincy thats why its important to have other back up to support the testing results. If you would have apllied the gel before then it may have given a more clinical pictures. If dr did not tell you to apply the gel he did it for a reason. from reading Dr john nots he has guys apply gel before blood work, you may be an exception for some reason I do not know...

More blood test results, ordered by the urologist that found my varicocele. Later the same day as the AM blood was drawn (results above), PM blood was drawn (about 7 hours after applying Androgel which was applied right after the 8:30 am draw).

I must not be absorbing Androgel, OR, it goes straight to my kidneys and down the toilet. OR it could be my T is just from the Testes alone thanks to HCG, and Androgel isn't doing much for me at all.

One thing I know for sure is that injections were working, I just didn't like the weekly rollercoaster and occasional bleeding, but I guess I'll just have to deal with that.

I plan to talk to Dr. Crisler about going back to injections plus hcg.

Given the consistancy it shows in the blood results that its low testosterone. also see how e2 is dropping as day goes on!! The inconsistency is rather strange BUT if you had serum free estrodial checked it may show a different pics in relationship to e2. It looks like you are pissing it out more then anything and the second blood test just confirms that. Could it be you are metabiolisming it too fast de to some other hormonal imbalance such as cortisol? ...hmm what about DHT ?

More blood test results, ordered by the urologist that found my varicocele. Later the same day as the AM blood was drawn (results above), PM blood was drawn (about 7 hours after applying Androgel which was applied right after the 8:30 am draw).

I slapped on 10% cream 1 ml and test only came up to 307 3 hours before the test so this means I was not absorbing it. Urine test are tricky because an what looks like an excess may be defieincy thats why its important to have other back up to support the testing results. If you would have apllied the gel before then it may have given a more clinical pictures. If dr did not tell you to apply the gel he did it for a reason. from reading Dr john nots he has guys apply gel before blood work, you may be an exception for some reason I do not know...

The only instruction given by Dr. John was to be stable with Androgel and HCG administration for 4 weeks before the urine test. He also wanted me not to take any Pregnenelone or DHEA during these 4 weeks. The only instructions from Rhein was not to take vitamins the day before or day of the urine collection. I complied with these instructions. That urine was collected 4/21.

On 4/26 the day the blood was drawn twice, I did not put Androgel on before the 8:30AM blood test. I put the A-gel on about 8:45 (after the draw), then the other blood test was drawn 7 hours 50 minutes later.

Dr. John did not order either blood test. My PCP ordered the first one, and my urologist ordered the 2nd, and he knew I had had blood drawn that same morning by the other doctor.

Jan, Thanks for the feedback and suggestions. I will mention these at my Thursday urology followup. At that followup, doppler ultrasound will be done on my nads to measure the varicocele. Based on what this urologist told me already, he believes that thyroid issues, if any, could be related to low T. He told me he likes total T around 1000 and free T around 300, with Estradial mid-range, and that in achieving this, other organs get into gear. I was surprised at his knowledge of hormones, which seems comparable to Dr. John's. He has all his labs done in-house. I saw his willing to look at my serum levels as a bonus, since I was seeing him for the pain in my scrotum.

Last edited by wildfox; 05-07-2007 at 01:06 PM.
Reason: Yes, I meant 1000

Jan, Thanks for the feedback and suggestions. I will mention these at my Thursday urology followup. At that followup, doppler ultrasound will be done on my nads to measure the varicocele. Based on what this urologist told me already, he believes that thyroid issues, if any, could be related to low T. He told me he likes total T around 100 and free T around 300, with Estradial mid-range, and that in achieving this, other organs get into gear. I was surprised at his knowledge of hormones, which seems comparable to Dr. John's. He has all his labs done in-house. I saw his willing to look at my serum levels as a bonus, since I was seeing him for the pain in my scrotum.

You have probably ment T~1000, important is freeT and that he wants ~300 which is top of his range, good.
As you may know I am not comfortable with individual test specifically for FreeT, the test usually is a crook.
I explained it here:MESO-Rx - View Single Post - Attention all those on Sub-q injections
Also I personally do not like in-house laboratories.
Even the national laboratories have a quality issues.
You will newer hear about some little lab on dead end street.
But I am not a doctor, just ED suferer.

You have probably ment T~1000, important is freeT and that he wants ~300 which is top of his range, good.
As you may know I am not comfortable with individual test specifically for FreeT, the test usually is a crook.
I explained it here:MESO-Rx - View Single Post - Attention all those on Sub-q injections
Also I personally do not like in-house laboratories.
Even the national laboratories have a quality issues.
You will newer hear about some little lab on dead end street.
But I am not a doctor, just ED suferer.

Yes, I meant 1000. Thanks for spotting that. I editted my post. What I like about this urologist is that my insurance has already paid him and his in-house lab fees. I had to pay for the Urine labs and also Dr. John's fees out of pocket. If I don't have in-house labs, I have to use Labcorp, otherwise I have to pay for everything.

I like Dr. John and am very grateful for all his help. However, having insurance pay for this stuff is very nice. I won't say yet that I found a local alternative. Been there, done that....with disappointment, which is why I've stuck with Dr. John. That this urologist wants to be thorough about my hormones was a welcome surprise. When I told him what I was taking (1 packet Androgel daily, 200 iu hcg every other day) he commented that he's never seen those amounts to be enough. Hmm. He seems to be in the race, at least.

Yes, I meant 1000. Thanks for spotting that. I editted my post. What I like about this urologist is that my insurance has already paid him and his in-house lab fees. I had to pay for the Urine labs and also Dr. John's fees out of pocket. If I don't have in-house labs, I have to use Labcorp, otherwise I have to pay for everything.

I like Dr. John and am very grateful for all his help. However, having insurance pay for this stuff is very nice. I won't say yet that I found a local alternative. Been there, done that....with disappointment, which is why I've stuck with Dr. John. That this urologist wants to be thorough about my hormones was a welcome surprise. When I told him what I was taking (1 packet Androgel daily, 200 iu hcg every other day) he commented that he's never seen those amounts to be enough. Hmm. He seems to be in the race, at least.

One packet (5grams) of Androgel is rarely enough.
7.5gram or 10 grams is more likely.
You may want to reduce volume by using 10% Tcream
I found that I need to double the cream dose to make it equal at the blood level.
---------------------------------------------------
I used to use 10grams Androgel (latter reduced to 7.5)
10grams of 1% gel =100mg of testosterone.
so when I switched to T cream I started on the same amount of applied T, that is;
My cream is 100mg/gram so I used 1gram/day
Blood test came out short.
I increased to 2grams/day, next blood test will show me if that is enough.
AFAIK, Dr John's have 5% gell, going by same logic one would start at 2grams and then increase to 4, or just start at 4 and lower it latter if need be.

One packet (5grams) of Androgel is rarely enough.
7.5gram or 10 grams is more likely.
You may want to reduce volume by using 10% Tcream
I found that I need to double the cream dose to make it equal at the blood level.
---------------------------------------------------
I used to use 10grams Androgel (latter reduced to 7.5)
10grams of 1% gel =100mg of testosterone.
so when I switched to T cream I started on the same amount of applied T, that is;
My cream is 100mg/gram so I used 1gram/day
Blood test came out short.
I increased to 2grams/day, next blood test will show me if that is enough.
AFAIK, Dr John's have 5% gell, going by same logic one would start at 2grams and then increase to 4, or just start at 4 and lower it latter if need be.

Dr. John does have a more concentrated gel. It "frosted" on me, and I thought that was a problem. I also felt worse on it than I did on Androgel+HCG. I could ask him about prescribing the cream you mentioned from women's international.

Dr. John does have a more concentrated gel. It "frosted" on me, and I thought that was a problem. I also felt worse on it than I did on Androgel+HCG. I could ask him about prescribing the cream you mentioned from women's international.

While your urologist seem to be on top of his game and you got really lucky to find a good urologist all the ones I saw said I am normal and ask for psyche evaluation and prescription of paxil with tt of 305 ..IDIOTS !!

Dr. John does have a more concentrated gel. It "frosted" on me, and I thought that was a problem. I also felt worse on it than I did on Androgel+HCG. I could ask him about prescribing the cream you mentioned from women's international.

He may not like to support competition.
But there may be a absorption difference between gel an a cream for some people.
In my experience Androgel (a gel) got right thru me, never any hint of frosting, high blood T levels.
If Dr John's gel is similar just 5x more concentrated I would assume that gel should be better (absorbability vise) than cream.
Bottom line, one would have to try both, do blood test and see results.

I should hope that providing appropriate TRT for me would not be based on "competition". Right now the main part of my TRT is Androgel, and Dr. John gains nothing from my use of that. I doubt he makes much from my use of Signature Pharmacy products that he prescribes either. He certainly doesn't make much from my $50 VOV, compared to those who contract with my insurance, basically sitting on their ass saying "gee, I don't know what to make of this, you should see an endocrinologist, but you look good".

I'm sad at any implication that Dr. John is in competition or wants to avoid it. I know that he has had other doctors visit his practice so that they can learn from him.

From what I see here you need to go back to shots and if you want to keep E2 down try doing the shots 2 x's a week or even better every 3 days. With your HCG the 2 days each in between your T shots. So if you were going to do 100mgs a week of T this would be 43 mgs every 3 days.

From what I see here you need to go back to shots and if you want to keep E2 down try doing the shots 2 x's a week or even better every 3 days. With your HCG the 2 days each in between your T shots. So if you were going to do 100mgs a week of T this would be 43 mgs every 3 days.

i second that notion. Since swtiching to 2 time a week shots its been night and day with results and also a 22 lbs increase in 4 weeks of lean muscle as well

I should hope that providing appropriate TRT for me would not be based on "competition". Right now the main part of my TRT is Androgel, and Dr. John gains nothing from my use of that. I doubt he makes much from my use of Signature Pharmacy products that he prescribes either. He certainly doesn't make much from my $50 VOV, compared to those who contract with my insurance, basically sitting on their ass saying "gee, I don't know what to make of this, you should see an endocrinologist, but you look good".

I'm sad at any implication that Dr. John is in competition or wants to avoid it. I know that he has had other doctors visit his practice so that they can learn from him.

SO when does e2 peak according to tesotsterone injections vs the creame. SO if a person injects 48 hours you wll have a peak testosterone levels, but when approximately would that estrogen level be peaking or would it occur at that 48 hour mark or even a day or so later. Point being people that are taking armidex on the day of there shot are being mislead that it going to keep the e2 down from the injection at that time, but rather a few days later. If we could be given a chart when t : e2 comparision with armidex and t injection that would be peaking that would be an interesting thing to see..

SO if one is high on testosteorne metabolites in urine then what concludsion can be drawn?
Is the body not absorbing it or its it not being utlized once in the blood stream or is there possible kidney abnormalities